Individual
DR. CHERYL DENISE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
141 W 46TH AVE, GARY, IN 46408-3905
(219) 614-0793
Mailing address
PO BOX 32, GARY, IN 46402-0032
(219) 576-4775
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP1600X
Pastoral Counselor
Primary
—
—
104100000X
Social Worker
—
—
Other
Enumeration date
09/03/2009
Last updated
09/03/2009
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